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CNN Live Sunday

Medical Care in America: Debate Continues

Aired August 05, 2001 - 17:20   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
STEPHEN FRAZIER, CNN ANCHOR: Implied in the comments of Senators Hagel and Daschle and all political negotiations over patients' rights, is a belief that the United States enjoys the world's best medical care, but does it?

We will spend more time on health care with three guests, all of whom say the current system is a bit of a mess.

John Huff is an attorney specializing in health care law and policy; Quentin Young is a physician who supports a socialized medical plan, similar to Canada's; and Merril Matthews is a health care adviser who is against a socialized plan, who instead favors individual medical coverage plans.

Mr. Matthews, to you first. What do you mean by these individual plans? Do we go out by ourselves and buy medical coverage on an individual basis?

MERRIL MATTHEWS, AMERICAN CONSERVATIVE UNION: Absolutely. Every other type of insurance, individuals go out in the marketplace -- auto insurance, home owners, life insurance -- and they buy that insurance themselves.

What's happened in health insurance is, as a product of World War II, and certain tax breaks that Congress gave us, 90 percent of those under age 65 that have health insurance, get health insurance through their employer. So the employer decides what kind of policy you get, and many of us are not happy with that, and we would like to move to something else, but we get it through our employer, so we are very limited. A system in which people could go out and buy their own health insurance policies would work much better.

FRAZIER: Why is that a problem then? I think you explained earlier in our prior talks that this means the customer of the health care isn't paying the bill, so he is not really the customer.

MATHEWS: That's right. The system works right now, is that you get a tax break, if you get your health insurance through your employer, but not if you go on out in the individual market. Many people who are self-employed go out and get health insurance policies, but if you work for an employer who doesn't provide health insurance, you don't get that tax break. If you work for one who does, you can't get that tax break to buy something differently. If people got the same tax break, most people would go out, look into what we call the individual market, buy their own policies, and the interesting thing about it is now -- the wisdom used to be, group policies, those where you go through an employer was the only way to get affordable health insurance. Right now in most states, the only way to get affordable health insurance is to buy it on the individual market as a family buying their own policy.

FRAZIER: Wow, that's a big change. Mr. Huff favors that idea in general, but he points out something very significant, which is, this leaves the poor -- who can't afford to do that kind of thing -- out in the cold. What would you recommend, Mr. Huff?

JOHN HUFF, LAWYER: I think the poor, the people we should be giving assistance to, are the people that need it. The current system that Mr. Matthews described benefits (UNINTELLIGIBLE) and have the highest incomes. There's a factor of 13 to 1, between the highest income individuals on the lowest income individuals, in the benefit they get from the exclusion of what Dr. Matthews was describing.

What we ought to do is give a benefit to the people who need it and give them a tax credit to buy private insurance, what he described as an individual market, which could actually become a new type of group market. If we don't do that, we're going to end up with more and more people in a government-run system, which I don't think what the American people want.

FRAZIER: Dr. Young believes that a government-run system would work just fine -- and you point out, Doctor, Medicare has been one of the most efficiently run of all government programs.

DR. QUENTIN YOUNG, PHYSICIAN: Absolutely. Medicare is a 2 percent overhead compares to 15, 20, 30 percent waste in management in overhead costs in the private sector. It's arguably the most popular social policy we have in this country; it's a huge success.

What the American people want and deserve is to have the same universal coverage that people all over the world that resemble us, politically and economically, advanced industrial countries. They've all got it. We are spending twice as much per capita for a broken system. The system doesn't work.

It's costly, it's not user-friendly. Forgive me -- my colleagues, I think your proposals will fall and come to naught. The idea single that single insurance is cheap in the state, I don't know what state that's true. Families are looking at 5 - $10,000 a year policy coverage. We can solve this problem by letting the government do what it does well: collect the money and pay the bills, and then control the system in a way that we can utilize our vast resources and give the American people what they want: decent health care for everybody; everybody in, nobody out. Not the kind of goofy system we have now.

MATHEWS: While it is true most Americans would like to see a type of universal coverage, they don't want to see the universal rationing that goes on in all the other countries that have a national health insurance plan. All you have to do is go there, look at the quality of care, look at the waiting lines, look at the rationing, look at the lack of technology, and you will see what kind of systems they've created. Our system has problems; their system has problems but we don't want their problems.

FRAZIER: Isn't it true that this country is where most of the innovation and medical advances are coming right now with a system we all don't like and is moving medical science forward? But you are discussing the delivery of that.

YOUNG: Yeah. And also the innovation is ironically, largely, the product of government expenditures through the national institutes of health. I'm not a buff for government but I think government bashing and anti-tax views distort the issues. I have been to the countries that have been mentioned; they have problems.

Bear in mind, we're spending twice per capita, none of them have problems that doubling the budget won't solve. I will be walking across the state of Illinois next week in support of the Burnidine (ph) Amendment, which proposes to change the constitution of Illinois, to guarantee health care on the state level. It's 167 miles. I have been training. And I hope to get the state legislature to vote for what the people of Illinois has voted, up to 91 percent in favor of, in referenda in recent years.

FRAZIER: Let me ask you, Doctor: on a plan like that, once health care -- and this can go out to all of you gentlemen. Once health care is competing for government resources with the other issues the government take up, such as defense, education, energy development, or relief for emergency hit areas such as Florida, as we are looking at now -- isn't it vulnerable to cut backs?

YOUNG: It is. That's a fair question; I concede that. But it's not mortally wounded as it is in the sector with the corporate corporations, gauging huge profits. The government is a popular government so far, although the enormity of the finance support from the big corporations is distorting it, as we all know.

Having said that, I believe the people will make sure, as they do with Medicare, there will be adequate funding. The point is, we are spending the money now; let's get our money's worth.

MATHEWS: Doctor, there is not adequate funding in Medicare now! 1.9 million seniors have had their HMO benefits reduced or eliminated because there isn't an adequate funding in Medicare now, you know that.

YOUNG: Let me say, because that's a bad one. The corporations that got big money for taking the HMO patients dumped them, 1.9 million, you are absolutely right, because the profits weren't high enough. There were profits there, they just weren't high enough. Let me say this: I believe in markets for many things, doesn't work in health care.

FRAZIER: Let me give Mr. Huff the last word, because he has been waiting for a chance go. MATHEWS: Go Mr. Huff.

HUFF: The funding is a separate matter. It will be a question, whether it's a government-run system or a government-financed system through the private sector. What Dr. Young said: government can collect money, spend money, and then he said control the health care system. That's the danger.

Medicare, for instance, now, if you want to get more services than Medicare provides, you can't do it. The doctor is criminalized if he provides a service in excess of the Medicare amount. You can't pay for it out of your own pocket. All of the socialized systems run up against, as Mr. Matthews is describing, the problem of great promises, great costs and then rationing.

In England for instance, there are now a million people on the waiting list for 350,000 waiting for care, 350,000 people waiting to get on the waiting list. Because it's bureaucratically driven, they often show that they're making progress on the waiting list, they take simple surgeries, rather than needed surgeries. We don't want to politicize health care by turning it over to government, which means turning it over to politicians.

FRAZIER: With that, I will have to say, thank you all and I'm sorry we can't extend this conversation, as well as it's going. But I'm grateful to all of you for joining us.

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